Individual
JENNIFER R. BRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3918 PECAN GROVE RD, RUDY, AR 72952-9026
(479) 632-6337
(479) 632-5916
Mailing address
3918 PECAN GROVE RD, RUDY, AR 72952-9026
(479) 632-6337
(479) 632-5916
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA5231
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1048
OKLAHOMA LICENSE
OK
01
—
OT-A531
STATE LICENSE
AR
Enumeration date
09/07/2011
Last updated
09/07/2011
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